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See a sample rate comparisonHCPCS J1643 (Heparin Sodium) Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Injection, heparin sodium (pfizer), not therapeutically equivalent to j1644, per 1000 units
| Key Fact | Detail |
|---|---|
| Service Type | Drugs Administered Other than Oral Method Drugs, Administered by Injection |
| Common Place of Service | None 11 - Office 20 - Urgent Care Facility |
| Complexity Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for J1643 |
| Medicare Payment Limit | $3.007  |
| WAC Price | Lorem ipsum dolor sit amet consectetur Lorem ipsum dolor sit amet consectetur VisitBuyandBill.com |
National average reimbursement for HCPCS J1643 by major payers:
$2.99
$3.71
$3.91
$3.93
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HCPCS J1643
5 of 25 sample ratesHigher to lower in this preview
Altoona Regional Health System, Altoona Regional Health System
UPMC
$6.23Published rateKaleida Health
$3.73Published rateAscension Ne Wisconsin, Inc, Ascension Ne Wisconsin Surgery Center
$3.73Published rateCumberland County Hospital System Inc, Cape Fear Valley Medical Center
Cumberland County Hospital System Inc
$3.42Published rateUniversity Of California, San Francisco, Ucsf Medical Center
$3.00Published rate
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See a sample payer proposalHCPCS J1643 vs. Other Drugs, Administered by Injection Codes
The HCPCS J1643 code is part of the Drugs Administered Other than Oral Method services used for Drugs, Administered by Injection. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The HCPCS J1643 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| J1642-HCPCS | Low | Injection, heparin sodium, (heparin lock flush), per 10 units |
| J1643-HCPCS | Low | Injection, heparin sodium (pfizer), not therapeutically equivalent to j1644, per 1000 units |
| J1644-HCPCS | Low | Injection, heparin sodium, per 1000 units |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS J1643. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the J1643 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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